ALZHEIMERS DISEASE Dementia is a syndrome characterized by failure of recent memory and other intellectual functions that is usually insidious

in onset but steadily progresses. Alzheimers disease (AD) is the most common dementia, accounting for 60 80% of cases in the elderly. RISK FACTORS: 1. Age Predisposition the prevalence of the disease is at the age of 50 rapidly increasing to the age of 65 to 75 and at the age of 85 it has been estimated to afflict 35 50 percent of the old age population range. 2. Genetic factors It has been said that the presence of a mutated specific gene presence in chromosome 21 called the Amyloid Precursor Protein (APP) is associated with the onset of familial alzheimers disease. Another is the mutation of the gene Presenilin 1 and Presenilin 2 that can be found in the chromosome 14 and 1 respectively. The most recent genetic studies that is associated in the Alzheimers Disease is the presence of Apolipoprotein e4 alele in the chromosome 19

ANATOMICAL FEATURES AD brains show cortical atrophy with hydrocephalus ex vacuo. Gyri narrow, sulci widen and cortical atrophy is especially apparent in the parahippocampal regions. However, as the disease progresses, atrophy of temporal, frontal and parietal cortex becomes more severe.

HISTOLOGIC FEATURES Microscopically presence of Neuritic Plaque composed of the accumulation beta amyloid protein and the presence of neurofibrilliary tangle is the histologic mark of Alzheimers disease

CLINICAL PRESENTATION The earliest sign is typically an impairment of recent memory function and attention, followed by failure of language skills, visualspatial orientation, abstract thinking, and judgment. Inevitably, alterations of personality accompany these defects. Dyspraxia may be also present such as they cannot dress themselves or unable to operate kitchen appliances and others. DIAGNOSTIC The major neurologic exam that is usually conducted to detect cognitive dysfunction is the Mini Mental State Examination (MMSE) tool. This is to support diagnosis for dementia and its stages. The most common diagnostic imaging procedure is the use of MRI and CT scan to detect anatomical pathology of the disease and to identify if the pathological structure is of the Alzheimers Disease. MEDICAL TREATMENT The use of cholinesterase inhibitor is clinically proven to treat Alzheimers Disease. Tacrin is the first cholinesterase inhibitor that was first developed. But this medication can cause liver toxicity and thus blood monitoring is advisable to the patient to monitor liver function REFERENCES:

D. Purves, e. a. (2004). Neuroscience. U.S.A: Sinauer Associates, Inc. H.Fillit, e. a. (2010). Textboof of Geriatric Medicine and Gerontology. Philadelphia: Saunders Elsevier Inc. R., R., & S., D. (2012). Rubin's Pathology - Clinocopathologic Foundations of Medicine. Philadelphia: Lippincott Williams & Wilkins.